Juvenile Idiopathic Arthritis-associated Uveitis at an Italian Tertiary Referral Center: Clinical Features and Complications. (February 2015)

• Record Type: Journal Article
• Authors: Paroli, Maria Pia; Abbouda, Alessandro; Restivo, Lucia; Sapia, Alfredo; Abicca, Irene; Pivetti Pezzi, Paola
• Is Part Of: Ocular immunology and inflammation. Volume 23:Number 1(2015)
• Page Start: 74
• Page End: 81
• Publication Date: 2015-02
• Subjects: Eye -- Diseases -- Immunological aspects -- Periodicals; Eye -- Inflammation -- Periodicals; 617.7
• DOI: 10.3109/09273948.2013.855798
• Languages: English
• ISSNs: 0927-3948

Abstract

<abstract> <title>Abstract</title> <p> <italic>Purpose</italic>: To describe the frequencies and risk factors of ocular complications and poor visual outcomes in children with juvenile idiopathic arthritis (JIA).</p> <p> <italic>Methods</italic>: Retrospective cohort study, including 69 consecutive children (116 eyes) affected by JIA-associated uveitis managed at a tertiary uveitis clinic.</p> <p> <italic>Results</italic>: The incidence of visual loss to the 20/50 or worse threshold was 0.04/eye-year (EY) and to the 20/200 or worse threshold was 0.02/EY. The most common complications at baseline were posterior synechiae (52%), band keratopathy (38%), and cataract (12%). Risk factor for a visual acuity threshold of 20/50 or worse included hypotony (<italic>p</italic> = 0.01; hazard ratio [HR] 3.7; 95% CI 1.3–10.4); anterior chamber flare >1 (<italic>p</italic> = 0.04; HR 1.3; 95% CI 0.5–3.4); a positive antinuclear antibody (ANA) (<italic>p</italic> = 0.02; HR1.4; 95% CI 0.8–2.4). Hypotony and positive ANA are also associated to the 20/200 or worse threshold (<italic>p</italic> = 0.03; HR 5.1; 95% CI 1.1–23.9 and <italic>p</italic> = 0.04; HR 1.0; 95% CI 0.4–2.3; respectively). Use of immunosuppressive drugs was associated with a reduced risk of visual loss of 20/200 or worse (odds ratio 0.14, 95% CI, 0.02–1.29; <italic>p</italic> = 0.04).</p> <p> <italic>Conclusions</italic>: Loss of vision and ocular complications still occur among children with JIA-related uveitis. Prompt diagnosis and a strict follow up associated to immunosuppressive therapy may decrease the poor visual outcome.</p> </abstract>